Coding

Ensure inpatient coders get an MS-DRG refresher to perfect code assignment and strengthen reimbursement.

CMS recently agreed to settle an ongoing dispute with inpatient rehabilitation facilities (IRF) over the backlog of denied Medicare claims.

The Revenue Integrity Symposium is filled with so much information that applies to all levels of revenue integrity from those of us in the trenches to management. It will be my third year attending and I’m still finding new sessions to attend. And the networking is amazing!

The CDC has posted the FY2020 ICD-CM final code changes, and there were no changes to the proposed list of 273 new, 30 revised and 21 invalidated codes that were released in the proposed inpatient hospital prospective payment system rule, April 23.

If you only bill using the CMS-1500 claim form, then you’ve probably never seen a revenue code. But if you need to bill for facilities, you know revenue codes play an important communicative role between providers and insurers. UB-04 claim forms sent to an insurance company without a revenue code associated with each charge will be rejected.

CMS recently released the 2020 ICD-10-PCS Official Guidelines for Coding and Reporting, which include a new section for the accurate reporting of brachytherapy procedures. 

Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.

On June 11, CMS published a Request for Information (RFI) as part of its Patients Over Paperwork initiative to collect public input on ways to reduce unnecessary administrative and regulatory burden.

The NCCI manual can be a powerful tool for revenue cycle staff to understand the intricacies of CMS modifier rules and Medicare edits.

The new instructions replace those issued via the April update to the Outpatient Prospective Payment System.